{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T04:33:45Z","timestamp":1745469225121,"version":"3.40.4"},"reference-count":26,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Digestion"],"published-print":{"date-parts":[[2014]]},"abstract":"<jats:p>Background: The symptom improvement rate is low with proton pump inhibitors (PPIs) in nonerosive reflux disease (NERD). The underlying pathogenic mechanism is complex. Esophageal motility disorders (EMDs) are thought to be a factor, but their prevalence, type, symptoms and the role played by gastroesophageal reflux (GER) in symptom onset have not been fully investigated. Aim: To investigate the role of GER in symptom onset in PPI-refractory NERD patients with EMDs. Methods: This study comprised 76 patients with PPI-refractory NERD. Manometry was performed during PPI treatment and patients were divided into an EMD group and normal motility (non-EMD) group. Then, multichannel intraluminal impedance-pH monitoring was performed and medical interviews were conducted. Results: Nineteen patients (25%) had an EMD. Data were compared between 17 patients, excluding 2 with achalasia and 57 non-EMD patients. No significant differences were observed between groups in 24-hour intraesophageal pH &lt;4 holding time (HT), mean number of GER episodes or mean number of proximal reflux episodes. The reflux-related symptom index (\u226550%) showed a relationship between reflux and symptoms in 70.5% of EMD patients and 75% of non-EMD patients. In the EMD group, the score for FSSG (Frequency Scale for the Symptoms of GERD) question (Q)10 was significantly correlated with the number of GER episodes (r = 0.58, p = 0.02) and the number of proximal reflux episodes (r = 0.63, p = 0.02). In addition, the score for Q9 tended to be correlated with the number of GER episodes (r = 0.44, p = 0.06). Conclusion: Our results suggest that some PPI-refractory NERD patients have EMDs, and that GER plays a role in symptom onset.<\/jats:p>","DOI":"10.1159\/000356222","type":"journal-article","created":{"date-parts":[[2014,1,20]],"date-time":"2014-01-20T09:39:18Z","timestamp":1390210758000},"page":"61-67","source":"Crossref","is-referenced-by-count":6,"title":["The Role of Gastroesophageal Reflux in Relation to Symptom Onset in Patients with Proton Pump Inhibitor-Refractory Nonerosive Reflux Disease Accompanied by an Underlying Esophageal Motor Disorder"],"prefix":"10.1159","volume":"89","author":[{"given":"Shinya","family":"Izawa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasushi","family":"Funaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihito","family":"Iida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kentaro","family":"Tokudome","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhiro","family":"Tamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naotaka","family":"Ogasawara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makoto","family":"Sasaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunio","family":"Kasugai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2014,1,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00630.x"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1080\/00365520510023260"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9270(03)00009-1"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-001-0023-6"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1159\/000226088"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-3565(04)00288-5"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-008-2214-5"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2007.03350.x"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2007.145581"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1023\/A:1018802908358"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00966.x"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2006.00825.x"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-004-1417-7"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2008.02119.x"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.670"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2006.00787.x"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2012.07074.x"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2011.06969.x"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2003.07188.x"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1023\/A:1017992808762"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2007.04987.x"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1097\/01.mcg.0000152782.22266.7c"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-3565(04)00010-2"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2011.04742.x"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200009000-00010"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2011.01.016"}],"container-title":["Digestion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/356222","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/dig\/article-pdf\/89\/1\/61\/4035369\/000356222.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/dig\/article-pdf\/89\/1\/61\/4035369\/000356222.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T18:16:19Z","timestamp":1745432179000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000356222"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2014,1,1]]},"published-print":{"date-parts":[[2014,1,20]]}},"URL":"https:\/\/doi.org\/10.1159\/000356222","archive":["Portico"],"relation":{},"ISSN":["0012-2823","1421-9867"],"issn-type":[{"type":"print","value":"0012-2823"},{"type":"electronic","value":"1421-9867"}],"subject":[],"published":{"date-parts":[[2014]]}}}